Building Community Resiliency and Healing: Preparing for, Responding to, and Recovering From Community Trauma and Disasters

Moderator: Lindsay Paulette-Chapman
July 23, 2013
11:00 am ET

Coordinator: Welcome, and thank you for standing by. At this time all participants are in a listen-only mode until the question-and-answer session. Today’s conference is being recorded. If you have any objections you may disconnect at this time.

I would now like to turn the call over to Lindsay Paulette-Chapman. Thank you. You may begin.

Lindsay Paulette-Chapman: Hello and welcome to Building Community Resiliency and Healing: Preparing for, Responding to, and Recovering from Community Trauma and Disaster.

Today’s webinar is sponsored by the Substance Abuse and Mental Health Services Administration’s Resource Center to Promote Acceptance, Dignity and Social Inclusion Associated with Mental Health, also known as the ADS Center. SAMHSA’s the lead Federal agency on mental health and substance abuse and is located in the U.S. Department of Health and Human Services. Please join the ADS Center listserv to learn more about social inclusion, and including upcoming webinars, new resources, and events.

The webinar will be recorded. The presentation video archive—including closed-captioning and a written transcript—will be posted to the SAMHSA ADS Center Web site at in mid-September. The views expressed in this training event do not necessarily represent the views, policies, and positions of the Center for Mental Health Services, the Substance Abuse and Mental Health Services Administration, or the U.S. Department of Health and Human Services.

Our presentation today will take place during the first hour and 15 minutes, and will be followed by a 30-minute question-and-answer session. During that time please press star one on your telephone to ask a question. You will enter a queue and you will be invited to ask your question in the order in which it was received. Upon hearing the conference operator announce your first name, please proceed with your question.

Questions can also be asked using the online question feature at the top of your screen. Due to limited time we may not get to all questions. If your question is not answered or you want further information, the presenters’ contact information is provided at the end of this presentation, so you can contact them directly. Now on to our teleconference topic.

Typically, a disaster or traumatic event is very stressful for anyone to deal with whether or not the individual has a pre-existing mental health condition. When a hurricane destroys a home or when street violence shatters the safety of a neighborhood, survivors can be left feeling alone, vulnerable, frightened, overwhelmed, and conflicted or confused about how to move forward. Some find it difficult to move forward without additional supports in place, while others are able to tap into inner strength, resilience, or resources to move towards safety and then on to the recovery process.

Any community seeking to rebuild hope and healing, after a disaster or traumatic event, should critically examine the diverse needs of all of its members, as well as its various strengths. All too often those with disabilities, mental health, or addiction conditions are left out of that assessment. And not only are their needs overlooked, but also their ability to help others.

By actively engaging a diverse network of individuals and organizations in the planning, response, and recovery efforts, communities can provide a more compassionate and effective response to disasters or traumatic events. Training peers to help support each other can empower the entire community. Those who have lived experiences with mental health or addiction recovery can, and do, serve as powerful advocates in their roles as agents in the community’s healing process.

The SAMHSA ADS Center works to increase awareness and support implementation and replication of socially inclusive practices, programs, and policies. Today our speakers will share their inspiring stories about how communities can work together to be more inclusive in preparing for, responding to, and recovering from disasters or other traumatic events. You’ll hear how those with disabilities and other functional and access needs are being integrated in national disaster efforts, how entire communities are being trained to respond with Emotional CPR, and how strategic partnerships are helping to significantly reduce violence in one community.

Our first presenter is Dr. Daniel Fisher who is the Co-Founder and Executive Director of the National Empowerment Center, a peer-run organization dedicated to promoting recovery and wellness of people with mental health conditions. Dr. Fisher has a Ph.D. in biochemistry, and while carrying out neurochemical research with the National Institute of Mental Health, he was diagnosed with schizophrenia. He recovered by building meaningful relationships. He found a biochemical explanation of behavior too alienating, and to humanize the mental health system he obtained an M.D. at George Washington Medical School and completed psychiatric training at Harvard University. He then worked as a community psychiatrist for 25 years.

Dr. Fisher co-founded the National Empowerment Center. And he will be discussing today his work in utilizing peer support and peer leadership following Hurricanes Katrina and Rita. Dr. Fisher will also be discussing how Emotional CPR, or eCPR, emerged from this post-Katrina work and how peers can play an important leadership role following a disaster or emergency.

Thank you for joining us Dan. You may begin.

Dr. Daniel Fisher: Thank you very much Lindsay. It’s a pleasure to be here. And I’m going to address the role that peers can and have played following disasters, and go over Emotional CPR also.

So typically after a disaster, such as Hurricane Katrina and Rita in Louisiana, the expectation is that people with psychiatric disabilities will need to be helped. And in some cases that is definitely true. What is often overlooked is the fact that quite a few of us who have been through our own personal traumas and disasters are really very well equipped from our recovery experience to help others who haven’t yet experienced such a trauma or such a recovery experience.

So we, I’ll give you as an example. Following the bombing of the Murrah Federal Building in Oklahoma City in 1995, a number of people with lived experience, peers with mental health experience were very instrumental in helping many of the residents of Oklahoma City to recover. And similarly after the bombing of the Twin Towers in New York City and 9/11, also there was a very strong peer component, so that people were able to utilize their experience of recovery to help others.

Therefore, when Hurricane Katrina struck in 2005, it was not unexpected that I and a number of peers rallied together to help the people of Louisiana. And we formed a national group very quickly and met through teleconference, called ourselves Consumers Organizing for Recovery after Katrina or CORK. We also started to connect and we found that connecting with local people is extremely important of course.

And through SAMHSA we were able to get the names of several local consumers and then we called the group Louisiana CORK or LaCORK. And these connections we established within 2 weeks of the hurricane and we were able to start planning, training, and setting up the curriculum to train peers locally within Louisiana to respond to this disaster.

Other peers across the country who responded, Patrick Hendry from Florida, he drove an RV up from Mississippi to assist people there. Joseph Rogers and members of the National Mental Health Consumers’ Self-Help Clearinghouse of Pennsylvania helped the people in Texas. And our own group was organized by myself and staffed with the National Empowerment Center.

And we had to negotiate with local authorities. At first, the Department of Mental Health and the Red Cross didn’t really see that there would be a role for peers. But with SAMHSA’s help and with our own my contacts across the country, we were able to get the authorization by the Department of Mental Health in Louisiana to come and start training peers there. So it’s very important to establish a collaborative working relationship with the local decisionmakers.

So we developed a curriculum that involved healing from trauma, providing peer support, cultural competency, how to set up a warmline. And we worked, the local group that we worked with in Louisiana is called Meaningful Minds of Louisiana. And they’re run by people with lived experience of recovery. And if you go through, the slides have some summary of these points. Slide 6 goes through the history. Slide 7 goes through the organization of LaCORK. And slide 8 tells about the other workers that came down.

Slide 10 describes the components of this training curriculum. And we trained three different groups of peers in Louisiana, three different sites: New Orleans, in Baton Rouge, and in Lafayette. And this was very difficult to do because it was hard to find housing for the national trainers that we flew in. There were about five national trainers that we flew in to these different sites. It was difficult to organize the peers together because communication was very difficult. A lot of things were very chaotic.

But this planning of the training and the carrying out of the training, which was all done by peers, really helped galvanize and give purpose and meaning to the peers in Louisiana. I think it helped a great deal in their recovery. So instead of being victims, they really saw themselves and really worked as people taking charge, not only of their own lives but assisting other people in taking care of their lives.

Churches were very helpful. Other volunteer organizations such as Extra Mile were very helpful. Several of the peers went on the radio to find housing for trainers that came in and sites for the training.

And the next slide on peer support training goes over really how we carried out the training. And we worked closely also with SAMHSA’s Emergency Response Center (SERC). That’s where the funding for the trainings occurred. And I just want to say, on a personal note, I was so touched by the peers of Louisiana.

One of our calls, we were asking why they stay so involved? And they said, there’s one woman, Nelda from Alexandria, and she said, “Because we love each other.” And they really showed genuine love and support for each other in the aftermath of first Katrina and then Rita, this one-two punch. And our trainers remain involved for several years because it does take several years to carry out this relief and recovery.

And one of the trainers from Oregon, David Romprey, he called it the Hurricane of Hope. And he said that really it brought out hope in people, the disaster itself. Many people were able to, because they were able to rally so well.

So the next steps that were involved were to submit to FEMA a grant for continued support of peers and Meaningful Minds of Louisiana was the entity applying, and they were successful in getting some funds for continuing support of peers. The National Empowerment Center continued to assist Meaningful Minds by providing ongoing support for warmlines. Warmlines are just short of a hotline. That’s when people are just feeling very isolated and often telephone can help a great deal in terms of support. And setting up peer support centers and also working out housing and other points of support.

So then we were able, through assistance from Oklahoma, to assist Meaningful Minds in becoming a nonprofit organization. And that enabled them to get funding from some foundations. And the outcomes are shown in the next slide. Peers were hired by local agencies to provide paid peer support. Peers gained confidence and they learned how to run a nonprofit. And they overcame a lot of the negative perception, stigma and discrimination that peers often experience. And overall I think most people would say that enhanced their own recovery by actively engaging in this fashion.

So the next slide is really another outcome of these trainings. Many of us felt that it would be good to have a training proactively to train peers and other community members ahead of time before a disaster happened. It’s very hard to create these trainings right after a disaster. So we developed a program called Emotional CPR which really was based on the work that we had done after Katrina. It’s based on Psychological First Aid and based also on just our recovery experience. And it’s a public health approach and it’s really for anyone in the community to help anyone else through an emotional trauma, whether it’s through disaster or personal issues.

And next slide really goes over what some of the foundations for Emotional CPR are. And one of the important ones is trauma-informed approach, and there’s more information on that in the appendix at the end of my slides. But just briefly, trauma really involves disconnection and disempowerment. And these are two of the first elements addressed by Emotional CPR because the C for Emotional CPR is connecting and the P is empowering.

So we immediately addressed the impact of trauma. And we’ve used information from the Adverse Childhood Experience Study, from open dialogue. I mean we try to be respectful, nonjudgmental. We also work towards mutuality which is an important part of creating a safe setting environment after a trauma, personal or disaster.

It’s very—Emotional CPR is very culturally attuned because you start where the person is to their culture. And you always enter into the relationship of assistance with great respect for the healing capacity the person themselves and their community have. You don’t impose your own.

And the next slide just goes over the elements of Emotional CPR. And as I mentioned before, the first is connecting to, connect with compassion, concern; learn to communicate. The key, we fudged a little bit on empowerment in achieving a sense of purpose through passion. And the people in Louisiana really they really showed these very well. They had a great passion for helping one another and gaining purpose, and they were able to plan. And this really helps with in the sense of revitalization; people feel that their life is worthwhile.

The next slide just briefly shows one of the sort of the theoretical underpinnings of this Emotional CPR and that is that on the right you see two people, and imagine the whole community, connected both verbally and emotionally on their heart-level and their mind-level dialogue, heart-to-heart dialogue. Trauma, loss, disaster can force people into a sense of isolation where they only hold on to their version of the world. They feel very insecure. They really can’t sort out their thoughts at times. And then through connecting and empowering people can return to the dialogue.

And so the next slide just gives some of the components of connecting, and we feel that it’s very important for you to connect at a very human authentic level. And be with people in a way that you’re real and understand them to be real. And just being with people instead of trying to fix them is very important.

And the next slide on empowerment goes over, as I mentioned before, trying to help people feel safe in a sense that they can have control of their life is extraordinarily important. And often sharing something of your own, not to burden them but to show that you’ve been through something similar in your life.
And the last slide is about revitalization. And it’s beyond recovery because it’s people that have been labeled also need to feel their vitality, their life force, their vital center experience again. They feel get-up-and-go. They feel they take steps towards their dreams again when they can start relating to other people again. And when you feel connection—you feel empowered—you can experience this sense of revitalization.

This Emotional CPR we’ve been teaching now across the country—probably around 600–700 people have been trained to be practitioners and people that are trained to be trainers. And we’ve also gone to Singapore twice and done training there. And Scotland has been showing interest. So it’s sort of a compelling need because everyone in the community needs to feel comfortable helping other people in the community, whether, as we said, it’s a personal or a community-wide disaster.

So thank you all very much, and later I’ll be available for questions.

Lindsay Paulette-Chapman: Thank you Dan for your work and for sharing how peers can do and play an important leadership role in the community healing process.

Slide 22: Dan sharing his vision. And in slides 23 and 24 he has an appendix that compares the principles of eCPR alongside the principles of the trauma-informed approach. Then following that chart on slides 25 and 26 he’s included additional resources for more information.

As our second presenter we’ll hear from Marcie Roth, the Director of the Office of Disability Integration and Coordination at the Federal Emergency Management Agency or FEMA where she leads the agency’s commitment to help those with disabilities and other access and functional needs before and during and after emergencies or disasters.

Ms. Roth was appointed by President Obama in June 2009 to be the Senior Advisor on Disability Issues for FEMA. Once at FEMA she developed a new Office of Disability Integration and Coordination where she now serves as Director. Previously Ms. Roth was the President and Chief Executive Officer of Global Disability Solutions Group.

Ms. Roth has led private-sector response to the survivors with disabilities for Hurricanes Katrina and Rita, and she has received commendation by the White House for her efforts following the 2001 terrorist attacks. Over the past 20 years she has held numerous leadership positions with national disability groups and organizations and is frequently consulted for her expertise on how to integrate those with disabilities into disaster preparedness, response, and recovery. Today Ms. Roth will be discussing FEMA’s important work at integrating the needs of those with disabilities and mental health conditions in their preparedness, response, and recovery initiatives.

Thank you for joining us Marcie. You may go ahead.

Marcie Roth: Thank you very much for including me. And I want to thank Dan for his very great presentation just now. I want to thank the SAMHSA team who has put this together. This is just a great opportunity to talk about what we’re doing at FEMA that is inclusive of the whole community.

If we could start with the slide on FEMA’s mission. I thought it would be helpful for folks to have an understanding of what our mission is. And you will notice that our mission is to support our citizens and first responders and to work together to build, sustain, and improve our capacity to prepare for, protect against, respond to, recover from, and mitigate all hazards. Next slide please.

It’s important that folks understand that this is a mission to work together. And I thought it would be helpful as well for people to have an understanding of when FEMA does respond. We only respond after there’s been a request from either State governors or tribal leaders, and when there’s an assessment of damage that would determine the level of disaster. And then once there is a Presidential approval that there is in fact enough damage, then that’s the point at which FEMA typically begins the long process of supporting the State in recovery. Next slide please.

And in keeping with the President’s national preparedness goals, it is especially important that the whole community has an important place in the preparedness of the Nation. And in order for this to be successful, we need to ensure that the whole community has equal access, and that we’re meeting the access and functional needs of all who may be affected. And that there be consistent and active engagement and involvement throughout planning and all the way through recovery.

So, next slide please. One of the ways that we achieve that is through the work of the Office of Disability Integration and Coordination. The role of my office is not to handle disability issues but rather to work both in the agency and with all stakeholders, public and private, to provide guidance, tools, methods, and strategies to integrate and coordinate inclusive emergency management.

So next slide please. We had a team of—it’s a growing team that will by the end of this year be well over 70 people who are disability integration advisors. These are all folks who have a particular expertise in disability-inclusive community engagement, and have a broad cross-disability understanding of disability inclusion. Next slide please.

Our role is both during what we call steady state and during deployment. So during steady state we serve as advisor to the senior leadership of the agency, and particularly to the Advisor and the regional administrators. And then during deployment we serve as advisor to the lead for that particular disaster, also known as the Federal coordinating officer.

Next slide please. And when we talk about disability, I want to be clear that we’re using the definition that’s in the Americans with Disabilities Act. And so this definition includes people who have a physical or mental impairment that substantially limits one or more major life activities.

And so I want to be clear that we use that definition and the very broad descriptions of who is included. And certainly the people who require mental health support, people who have—whether they have a diagnosis of an illness, or whether they have a record or are regarded as having mental health needs—then these are folks who not only are we planning for, but more importantly we want to make sure that we are planning with. And I’ll talk more about that in a little while.

Next slide please. We have moved away from using the terms “special needs” and “vulnerable.” We are far more focused on a rights-based perspective rather than a needs-based perspective. We see the terms “special needs” and “vulnerable” as people who are the recipients, not as active participants.

And folks—next slide please. Folks will often say, “Well, does it really matter, you know, does the language really make a big difference?” And I would argue that language drives behavior. And if we want people to be fully included, that we do in fact need to use language that doesn’t separate people and have a separate plan for people with disabilities. I think Mark Twain said it best when he said, “The difference between the right word and the almost right word is the difference between lightning and a lightning bug.”

Next slide please. So there are a number of Federal laws that prohibit discrimination in emergency programs on the basis of disability. For us in the Federal agency, most notably it’s the Rehabilitation Act which does have an impact on all Federal money that is spent in emergency programs. And then of course there are a number of other laws that apply as well, certainly with the Americans with Disabilities Act, the Stafford Act, Post-Katrina Emergency Management Reform Act, Fair Housing Act, Architectural Barriers Act, and even the Individuals with Disabilities Education Act as well as the telecommunications in the 21st century—the Communications and Video Accessibility Act.

Each of these, next slide please, applies in all emergency programs from preparedness and exercises before a disaster to notification, evacuation, and transportation when folks need to go to a different, safer environment. Sheltering, including sheltering in the general population environment which is the appropriate place for most people unless they have an acute medical need. First aid and medical services for those folks who do in fact need medical care, and then temporary lodging, and housing, transition back to the community, cleanup and debris removal. These laws apply across the board in all aspects of disaster preparedness, response, and recovery.

Next slide please. And there are a number of key principles that we’re guided by. These key principles include equal access, physical access, access to effective communication. Next slide please, inclusion, integration, program modifications, and of course all of this is at no charge to the individual.

Next slide please. I think one of the best ways to describe the transition is the paradigm shift that is underway is that historically people with disabilities have been viewed as a liability in emergencies and disasters. And FEMA and our partners are investing in the development of knowledge and skills among people with disabilities so that we are able to prepare individually for our own needs, for our family’s needs, and then as well to perhaps be of an asset to the neighborhood, to the community. And for many people, in fact, to become a national asset including our team and including many others who are playing a very important role, some of whom, you’ve already heard from Dan, and some of whom you’ll be hearing from later on this morning as well.

Next slide please. So where do you fit in? Well, each of us has a place in emergency management. Each of us, whether it’s your own personal preparedness, the preparedness of your family, your neighborhood, your community, everyone has a part to play. And we strongly encourage you to get involved in your local community. And we do have some resources at the end of my slides to provide you with more information.

Next slide please. It’s particularly important that we do in fact do the planning so that everyone has the opportunity to receive the support that they need in the general population shelter. And this will require active participation from community leaders so that adequate planning occurs in advance. This involves of course individuals who may be affected. And it also involves those community members who may be able to provide some technical assistance and guidance about how to accommodate people who may have mental health support needs, who may be in a situation where they need access to medication or may need a quiet area. And it’s important that people are involved in this conversation before the disaster hits.

Next slide please. And it’s very important that the community works together. We need to make sure that families and neighbors are involved in accommodating people with disabilities. We need to make sure that children and adults are planned for. And it’s very important that the whole community really seriously considers how to optimize those limited community resources by making sure that everyone has the ability to benefit from emergency programs, and that we keep people out of the acute care environment which is at such a premium especially in a disaster.

Next slide please. One of the ways that we go about this—FEMA has a personal assistance services contracts that we make available to States. During Hurricane Sandy the State of New York asked us to provide personal assistance service providers to the shelters. And so we were able to bring in 250 personal assistance service providers through the State to be able to provide the kind of assistance and shelters that individuals need in order to maintain their health, their safety, and their independence.

Next slide please. And the requirements for those contracts are that of course there is an emergency or a major disaster, and that the request comes to FEMA from the State or from a tribal or territorial government. When at the point at which they determined that the shortfalls within their State have been determined.

Next slide please. All of this requires partnership. And so we work very hard to engage disability community leaders, advocacy organizations, and others who are involved in community disability inclusion. And we encourage you all to work with us so that we can better prepare for what may be the next disaster that comes to your neighborhood.

Next slide please. We believe very strongly in the adage “nothing about us without us.” And you’ll see here that there’s a picture of a number of disability leaders, national leaders, Dan Fisher being one of them in this picture, and we believe very strongly that people with disabilities must be planning with and as we discontinue the previous approach of planning for people with disabilities.

Next slide please. So this is a winding to the end of my message. And I just want to make the point that disability-inclusive emergency management isn’t just good for people with disabilities. It really optimizes limited resources for the whole community. And it really strengthens the community-wide emergency management. And it strengthens the community’s ability to recover from what is often the most difficult and hard experience that folks have ever been through.

Next slide please. So now I’m going to provide you with several links about personal and community preparedness. So here are some links to be ready for the next disaster.

Next slide please. And for those folks who unfortunately have been affected by disaster, here are a number of links to provide you with access to how one applies for assistance after a disaster.

Next slide please. And then finally here are two pages of helpful links about the Office of Disability Integration and Coordination, about planning, about some of the approaches and resources out there.

And then finally on the last page is my personal contact information should you want to follow up with me directly. And I thank you very much for the opportunity to speak with you all today. And I will be available for questions at the end of all the presentations.

Thank you.

Lindsay Paulette-Chapman: Thank you so much Marcie for sharing with us FEMA’s vision and commitment of support to include those with disabilities in the Nation’s preparedness, response, recovery, and mitigation efforts.

As our third presenter we will hear from Margaret Upchurch who is a certified peer recovery support practitioner and certified wellness coach for older adults in the Mental Health Association in New Jersey where she volunteers at the Journey to Wellness Center.

After experiencing her own mental health challenges 4 years ago, she rebuilt her life and obtained training to become a wellness coach and peer recovery support practitioner. Ms. Upchurch currently provides peer-to-peer support to consumers with mental health or addiction issues, and she’s also a survivor of Superstorm Sandy.

Today she’ll share her story of how she recovered after her home was destroyed, and how she also worked tirelessly to help others in her community access the medication, transportation, and housing they needed.

Thank you for joining us Margaret.

Margaret Upchurch: Thank you very much Lindsay.

I’m very glad to be able to share my story with everyone today. I’d like to begin with my first slide shows you a view of the barrier islands being blocked off. It was October 28 at 6:00. We had to be out of the barrier islands. And as we were planning to leave we had to decide what we took with us and what we had to leave.

My experience a year earlier from Hurricane Irene was we had to leave for 2 days. Then we came back and everything was fine. So I instructed my son to just pack an overnight bag for a couple of days and we would stay with my brother and his wife in Barnegat. That’s a town 45 minutes south of Seaside Heights which is where we lived.

This is a view of my apartment as we left our home on October 28. We, I took pictures of it just, I don’t know, something just made me do it. It was raining pretty steadily and it was pretty windy, but we traveled without any issues whatsoever. We got to my brother’s house. We went to bed. And about 2 hours after going to bed we were awakened by large booms of thunder and pounding rain and whistling winds. So we were pretty much done with sleeping for the night. Around dawn things quieted down a little bit. The rain was still pretty steady but the winds were only occasional gusts. So everyone was up and my son begged me to leave. He didn’t want to sit in the house.

So I agreed to take him for a ride and see what was going on up at Journey to Wellness, which is a self-help center that I volunteer for. When we arrived at Journey to Wellness it was amazing. My boss and one of my coworkers were also pulling into the parking lot at the same time. It was not planned. We couldn’t reach each other on cell phones because cell phone service was really very bad at that point. But we all were very relieved to see each other. We hugged in the parking lot and then we went inside to see what was there. The center had power and it had phones. And since my brother lost power in the middle of the night, I hadn’t heard any of the news.

My boss, Michele, informed me that the barrier islands were damaged very badly and speculation was that, you know, it would be months before we could go back there. My son was not happy to hear that because we couldn’t spend months living with my brother and his wife.

Michele offered at that point to, you know we only packed an overnight bag. We didn’t know what we were going to do at that point. And she offered that we could use their RV that they had parked in the parking lot. They ran an extension cord so that we had lights and the refrigerator worked. And it was much better than being in the shelter of, you know, 400+ people. She also wanted me there to be close because she wanted us to go to the shelters and see what we could do to help. And we did.

This is a picture of the shelter that we worked at. It’s the Pine Belt Arena in Toms River. She wanted to go there and see what we could do rather than just sitting around. And quite honestly, having all the worries of where was I going to live, what was I going to do, we weren’t allowed back in our homes, we didn’t know when we would be. So I was all for being busy and keeping my mind off of it. So it began. We went to the shelter. This is a picture of the shelter outside of the little office that we were given by the DRCC; that’s the disaster recovery crisis counselors. They were very glad that we were at the shelters because we work with the mental health consumers and people with addiction issues. And we were peers. We’ve all, you know, been through all that so we have a mutuality with a lot of the people that were in that shelter. A lot of those people came from Seaside Heights, and a lot of our clients lived in Seaside Heights.

So we went to the shelter and my son stayed behind to answer the phones in the center until someone else came. We were very grateful to have the RV to sleep in. And the organization in charge of the shelters were—they weren’t equipped to handle the medication needs of the mental health and addiction population that they had in the shelter. So what we did when we got there was started walking around and talking to people and finding out what they needed and what they felt. And just talking to them and letting them know that, you know, we understood how they felt and that we were willing to help them.

We noticed very quickly that a lot of people needed medications. A lot of people were brought to us from the people running the shelter saying—this person has a diagnosed mental illness. Please decide where they want to be. And as soon as they would leave the room we would say, “Where would you like to be?” And we would then help them get a cot set up and get settled and be helpful. We noticed a lot of people didn’t have medications. So we called around to the local pharmacies, and they were more than willing to work with us. We would get everybody’s information. We would call in all the prescriptions that we needed, whether they were emergency refills or, you know, 3-day supply until we could get to their doctor to call in. And that’s what we decided to do for the people in the shelter.

I’m sorry. The pharmacies were wonderful. We would go there. They knew we were from the Mental Health Association in New Jersey and that we were working to help get the people in the shelters the medications that they needed. A lot of people were in the pharmacies at this point so the pharmacy assigned one pharmacist to us so that when we got there they were working strictly on our people so that we could get in and out of there and move on to the next person.

These were very long days. We were working from 8:30 in the morning until 10 p.m. at night when they would shut the lights off in the shelter. We would drive people to doctor’s offices, hospitals. We even took a few people to kidney dialysis every afternoon until they were moved out of the shelter.

The shelter had absolutely no news whatsoever. So we would take people to their homes—if we could get to them to see if they had power—so that they could get out of the shelter because otherwise they had no idea whether they could go back home or not. That would be something that I would really like to see change. They should have had some form of news in the shelter. A lot of these people were very glad when they found out that I too was affected by the storm. And I showed them how to apply for FEMA on a laptop that I brought from the center. I could help them get their medication. We got permission to get a mobile methadone unit brought to the shelter because we had a number of people that needed to take this because you can’t stop it abruptly. It’s dangerous. They could die. They could have seizures. Any number of things could happen. But MHA and the powers that be at the shelter were successful in getting a mobile methadone unit to come to the shelter every day to help the people in the shelter, and keep the people who needed the medication from going elsewhere and getting things taken care of differently.

Finally, 16 days after the storm we were allowed to go to our house on the barrier islands for the first time. They did it by street. They had us meet at a local mall and they bused us in there. We were allowed 1 hour and we were able to only take what we could carry. So this is what my home looked like when I got there. And just so you can see, you know, the house got hit by the boardwalk which is what the yellow tape is. It got knocked off the foundation. And in the middle picture my couch is sitting on the back end of its legs, leaning on my love seat. And my kitchen table is tossed in the middle there. And then the last picture, that big white object is my refrigerator laying on its back. All that occurred by the force of the water. I lived a block from the beach.

And that very same day that we were allowed to go into Seaside, I got a call from my brother about a place that I could rent across the street from him. So that kind of helped. I mean when I got to Seaside and opened the door—the door didn’t really open, it was already open—but I put the before and after pictures together so you could see the difference. See my living room before and my living room after, and my kitchen from the chair with the refrigerator behind it. And now the refrigerator is like laying on its back. Everything was covered in mold and it smelled so bad after being that way for 16 days.

There really wasn’t a lot that I could get. I was able to save a couple of my kids’ pictures from the wall. But all of my picture albums and my baby books from my kids were all underneath an end table and were damaged from the storm. And that’s the very hardest part of this is I’ll never be able to replace them. My kids are grown.

So, looking on the bright side, I went to Barnegat and met with the woman across the street from my brother. I loved the place. I signed a lease with her that day. And because I applied for FEMA on the first day, I was lucky enough to have from FEMA the money to put down security and first month’s rent. They couldn’t reimburse me for my personal belongings because there was restricted access to the islands until December 3. They were able to get out there probably the first or second of December but they were at my apartment and met me there on December 3 and they reimbursed me for the contents of my home the very next day. So on December fifth, which happened to be my birthday, I was able to go to Habitat for Humanity and pick out new furniture.

You know, I consider myself very, very lucky because I was able to find and acquire a place to live where a lot of people didn’t even know that they had to find a place yet. They weren’t sure of the condition of their house because they weren’t allowed to go over there for any length of time. And a lot of the people in the shelters, when they let us go back to the island, were too far away and didn’t get the chance to go because they had been moved from the local shelter to a shelter up in Monmouth County. And a lot of them had been moved to FEMA motels, most of which were in the far south of Jersey, Atlantic City area, 2½ hours away.

So they weren’t able to see what was going on. So I consider myself very, very lucky. With the money that I got from FEMA—and the fact that Habitat only charged me $500 for a house full of furniture and delivery—I was able to buy a TV and a Christmas tree so that at least my son and I would have Christmas that year.

The valuable lessons that I learned through this, this was my first disaster and better plan for the worst and hope for the best. I should have at least taken my pictures with me. Your “peerness” is a great comfort in times like these. A lot of people don’t accept help easily, and being talked to from a place of experience puts you on a level playing field. And it makes you feel like you don’t simply feel sorry for them because a lot of people that suffer from these type of things don’t want to be felt sorry for. They don’t really know what they need but they definitely don’t want to be felt sorry for. And don’t be afraid to share your story.

Everyone needs to know that you’re in the same place and you really do understand how they feel. Don’t profess to know everything. A willingness to explore the unknown is all that’s needed. And the connections made during this time will stay with me forever.

FEMA gave the Mental Health Association in New Jersey a grant because of the work that we did in the shelters during that time. There is approximately 150 case managers that have been hired through the Mental Health Association in New Jersey for a program called New Jersey Hope and Healing. It was so successful that they extended that program and the grant until February of 2014. And hopefully as long as the peer support is needed, New Jersey Hope and Healing will be there to give it to them because they go door to door. They go to the community. They go where people are to find what they need and do everything and help them with the resources they need to get what they need. And the next storm, my resource slide, I owe a great deal to Journey to Wellness Self Help Center and the Mental Health Association in New Jersey for helping me through this.

And I appreciate your time today. And thank you for having me.

Lindsay Paulette-Chapman: Thank you so much Margaret for sharing your courageous story with us. It’s really inspiring to hear, how despite your personal challenges, you were able to provide such vital support to other survivors, particularly peers.

The next—our final speaker is Willie Barney, Founder, President, and Facilitator of the Empowerment Network of Omaha, Nebraska. The Network is a united group of residents, leaders, and organizations working collectively to facilitate change and improve the quality of life in Omaha, Nebraska. For 22 years Mr. Barney has worked with corporate, nonprofit, and faith-based organizations in media, strategic planning, marketing, communications, and community building efforts.

Today he will discuss his impressive work with the Empowerment Network to address gun violence as a public health problem. He will discuss how he has strategically engaged the entire community in responding to the violence, encouraged community healing, and empowered survivors.

Willie, thank you so much for joining us. You may begin.

Willie Barney: Thank you very much for the opportunity to be here. I am very encouraged by the message that I’ve heard previously today. And it’s interesting as I was thinking about participating in this panel I wasn’t quite sure how everything would fit in. But I want to share with the group that in 2005 after Hurricane Katrina, that a number of individuals were brought to Omaha to try to find shelter and safety. We put together disaster, working with the Red Cross and others, a disaster relief plan. People were brought in but quickly after that they were put into hotels that were really in the southwest portion of the city, far away from most of the services that were needed, simply because of availability of hotel space.

And at that time I had left my corporate career and was working at my church and found myself on a daily basis getting into our church van and going and picking up people from the hotels and taking them to various—whether they need to go to the veterans’ hospital or to pick up or go to different places to pick up prescriptions or trying to locate more permanent housing. And it just really consumed myself and others.

And when—as I was talking to some of the other service providers, I said this is amazing how disconnected people feel, how many of them are still suffering from shock, pain, suffering, wondering where their relatives are and other things. No transportation to get where they need to go. One of our partners said, “You know Willie, this is not anything different in some ways than what many of our folks in our community are going through on a daily and weekly basis.” And I looked at her and really questioned it at first. But then I thought about it and the work that we were doing at the church and the number of people that were coming that had no transportation even on a daily/weekly basis. Lack of food, looking for food, needed help staying in their apartment—they are being evicted. It really made me think and look at the fact that in some cases—in some urban and rural communities—we’ve been experiencing what I call a silent hurricane for decades.

And specifically in the African American community for 50+ years in some cases. And what I mean by that is the pain and suffering, the lack of transportation, grief, gun violence, poverty—these are things that we had to take a hard look in 2006 in Omaha and realize that though we are known for very low unemployment, very high graduation rates and low violence, in some of our communities poverty is as high as 44 percent. Twenty-five percent of the people have no transportation, 18 percent unemployment rate, 47 percent graduation rate. And of the 44 homicides in our city, 28 of them were in one targeted geographic area.

So those are the things that we needed to take a look at in 2006 and really realized that we needed to address long-standing issues at the same time that we were addressing trauma. And in some cases trauma that has gone undiagnosed for years. We have thousands of people that have been impacted by gun violence, concentrated poverty, and other issues that really are suffering from posttraumatic stress disorder. Some of them have made the choice to self-medicate to try and deal with the situation.

So that was the background to the creation of the Empowerment Network. But we looked at it and we realized we’re not just victims. We have hundreds and thousands of graduates, more college graduates, more high school graduates, more degrees, more income. As a matter of fact the targeted area that we were looking at had $700 million of disposable income. So we began to bring people together and create what we called a strategic plan to really make more of a difference in our community addressing some of the social issues but really looking to how do we address long-term, long-standing issues.

You can see on this slide the areas of focus. It’s a holistic focus. We start with the faith community. We look at education. Today we want to focus specifically on our area of violence intervention and prevention since that deals specifically more with the public health area. But it is a holistic strategy.

One of the things that we wanted to do as I just give you a quick update, over the last 6 years of working together we have seen measurable change in our community where we created 2,500 summer jobs primarily for high at-risk youth, individuals that typically don’t receive opportunities to work during the summer. The graduation rate has increased 16 percent over the last 8 years. We have more kids going to college. Our reading and math scores have increased.

This is not just the work of the Empowerment Network, but many different organizations in Omaha that have made it a concentrated intentional effort to make improvements in our community, specifically the area of violence—gun violence. That’s a big topic across our community, across our Nation. We’ve seen gun violence through the end of 2012 decrease by 30 percent and that’s even higher in those target areas that we’ve focused attention on. And we’ve also really enhanced some of our cultural arts areas and helped—added additional access to healthy foods and quality health care.

Specifically in the violence area, over the last 6 years we have worked with over 500 individuals, it’s actually getting up into the thousands now, of individuals that have been directly impacted and worked with us. We also have 200+ organizations, and they come from a wide variety of community groups starting with grassroots individuals.

We do not want to have just a top-down strategy so we work directly with families that have been impacted by violence. We actually work with even those that have committed violence: gang members, former gang members, ex-offenders that are returning to the community. And we have listened to them. Not preached at them but listened to the situations and environments that they’ve grown up in and the situations that they’re trying to deal with. And many of them are definitely suffering from traumatic stress. Some of them compare it to growing up in a war zone where many of them have seen violent acts committed. Some of them have even seen people killed. And so how do you deal with that in a community that is trying to move forward but also has this emotional and physical trauma that they’ve been going through and experiencing?

So we listened to hundreds of folks: one-on-one meetings, small group meetings, large group meetings, forums, and summits. But we also try to look across the country at cities that had really tried to make some progress in these particular areas, one of them, the Boston TenPoint Coalition. We also traveled to Chicago; to the Ceasefire group in Oakland, California; and other cities that had made some progress. And many of the cities are still struggling with this issue of gun violence but some of them have made some progress.

So we took all of that information and working with the individuals in our community, we identified some of the root causes and issues that were driving gun violence and really started to look at what we could do to reduce gun violence in our community. But not only that, empower those individuals that live in the community to be a part of the solution. Some of the issues that were identified, of course, number one is unemployment.

On a personal note I believe that we have not put as much attention on this core issue specifically among African American young men but just in general. When the research was done recently by Gallup University, Gallup Corporation, they found across the world that the number one thing that people are concerned about is the ability to support themselves and the value of work. And when you have a community that is suffering 20–25 percent unemployment over a consistent amount of time, it creates other issues. Tie that in with lack of education, concentrated poverty, and these various issues that are outlined on this slide.

Other things—that personal conflict that may not mean much to anyone else, over time that personal conflict, a word said the wrong way, a look the wrong way, could end up in gun violence in certain communities. And you add number nine, easy access to illegal guns, and a culture that celebrates in some ways, encourages this type of behavior. It’s a real toxic mix that can happen in some of the communities.

And in light of that, what we have done is work with the neighborhood residents most impacted by those members that have lost family members. Those gang members, former gang member, and people in different neighborhoods that have wanted to turn their life around. Faith groups, community organizations, elected officials have come together to form what we call Omaha 360. It’s a collaborative strategy focused on prevention, intervention, enforcement, and recovery as well as support services. And we have engaged in efforts to make sure that this is a long-term commitment to make a positive impact in our community. So those are the things that we’re moving forward on.

As an example, one of the things that we strongly believe in is collaboration. Every Wednesday at 2 p.m. we have anywhere from 30 to 100 individuals that come together. We look at the recent issues of gun violence in the community. We look at long-term strategies. We look at trends. We have again faith communities, the Chief of Police, the Homicide Unit, Gang Unit, faith leaders, community organizations, youth development leaders, people from the school board all come together every week to address these issues on a comprehensive basis.

What we have seen as a result of some of the work, specifically during summer months where we have a summer jobs program, we have at youth—at-risk youth initiatives. Churches are doing Adopt-A-Block strategies. Our health community is providing access to healthy foods and vegetables, a holistic effort. We’ve seen a 51 percent reduction in gun violence during typically the highest point of gun violence in most cities in our northeast area. In addition to that at the end of December of 2012, we had the lowest level of gun assaults that we’ve have had in 7 years. Now this is something that happens periodically we’ll have a spike which we the last couple of months we’ve actually had a spike in violence. And it’s something that you have to continuously work on. It’s not something that you just finish it one day and you think it’s completely gone. You have to continue to be vigilant on it, continue to focus, and continue to bring collaborations together.

A few more slides and I’ll be done with this piece. What works? This is a big piece of issue—a big issue in our community across the country. These are the things that work. Collaboration works. Creating and building strong families, getting them more engaged and more families are a part of the solution. Jobs, we know that jobs and employment is one of the biggest factors that will reduce violence in our community. But these are the things that we have identified that are a part of our collaboration. Not one of them will solve this by themselves. But all of these things mixed together are the secret to success.

Moving forward we have a very, based on what we’ve learned over the last 7 years, we have a very comprehensive strategy starting with number one at the community healing process. As I mentioned when I started, we realized along the way that many of our communities and many of our individuals in our community have never walked through a healing process.

So we have partnered with Alegent Creighton Center and with the national group to bring in eCPR. We have trained 18 workers from different organizations and as we’ve moved out and worked with families; we do prayer walks in targeted neighborhoods. We walk with families that have been directly impacted by violence, either after a shooting or after a homicide, we go to the hospital. We pray with families. We work with them and get them connected with resources and anything that we can do to work with those families. Identify the need that they have. We have worked to really work with them throughout the process.

So we’re continuing to move forward. We have a comprehensive strategy from employment to arts, culture, reducing violence. We believe when communities come together, every zip code, every neighborhood can be transformed into a positive place for people to live.

I will end my comments there. Thank you so much for the opportunity to speak with you.

Lindsay Paulette-Chapman: Thank you so much Willie.

Your work in engaging and partnerships and empowering survivors to be agents of change and encouraging community healing after trauma is truly inspiring.

We appreciate the work you do and thank you for sharing your story with us.

Willie Barney: Thank you.

Lindsay Paulette-Chapman: You’re welcome.

Our speakers provided some great resources at the end of their presentations. And on slides 87 through 94 there are additional resources for you to learn more about the topics that have been discussed today. The resources are subdivided by topic on each slide, including disaster preparedness and recovery; peer support, resilience, and healing after trauma; and community-building resources.

We will now take questions from callers. To ask a question please dial star one on your telephone to be placed in the queue. Be sure to tell the operator your name. If you don’t wish your full name to be announced, then please only state your first name.

Questions can also be asked using the online question feature at the top of your screen. Because time is limited, please ask only one question. And after the conference operator announces your name you may ask your question. Once you’ve asked your question your line will be muted so the presenters may respond.

Operator, can we have our first question please?

Coordinator: There are none at this time. So if we could just give it a moment.

Lindsay Paulette-Chapman: Okay, great.

While we’re waiting for calls we can start with one question that came from the online system. And I’ll read it now. The question is “I am trying to design a community-based program for all human service agencies that create a cooperative plan for trauma-informed care and include law enforcement and emergency management. We already have CERT, CMH, peer recovery, and federally qualified health centers as interested partners. I am at a local health department in Ingham County, Lansing, Michigan. Please help me identify national agencies that will help invest in the plan. Thank you.”

So would Willie or Marcie—would one of you like to give your thoughts on any national agencies that might help invest in this kind of plan?

Willie Barney: I can’t really speak much to—well I can.

One thing that you might want to do though before you go after national support is continue to build your local network base. I would encourage you to get in people from the faith community, community organizations, neighborhood associations, and others if you haven’t done so. That will be critical.

And make sure that your strategy is inclusive of those on the ground, most impacted by these issues. And then work very closely with your city if you can, your mayor’s department, your grants department at the city, because there are national support operations and grants that may be available in partnership with the city, which is where we’ve been able to secure support for our reentry initiatives as well as statewide initiatives on gang and gun violence prevention. But it was after we had the other players at the table.

Marcie Roth: This is Marcie.

I can’t speak to funding but I can certainly encourage that you engage your independent living centers, the National Council on Independent Living, some of your partner organizations that serve people with disabilities. You know, it depends on the State that you’re in. It depends on what you’re—you know, who your coalition is. You know, you may quiz your coalition members to find out who they have relationships with.

And certainly I’m happy to put you in touch with our Disability Integration Specialist in your region if you contact me offline.

Lindsay Paulette-Chapman: Great. Thank you so much.

The next question also came through the online system, and we’ll direct it to Willie.

The question is “How is Omaha 360 funded and how would a local community go about funding their own?”

Willie Barney: Thank you for the question.

When we first started it was only three people in the room. And we went out and we started doing surveys and doing a lot of information gathering and working directly with those most impacted. And as we were doing that, some of the local foundations became very interested in it. And we actually brought some of the foundation heads—leaders—to meetings with some of those former gang members and even existing gang members. And we would just listen for 2 or 3 or 4 hours at a time.

They told their own story of how they got into it and what they hoped to be able to accomplish. And we started with just small projects that brought in some of those funders. And eventually we are a facilitating group, so much of the funding that is received we help facilitate it going to other organizations whether it’s the Urban League and then other direct gang intervention programs.

So we help facilitate the process. But because we developed a comprehensive network that has all these players at the table—and it’s recognized now by the mayor’s office, the police department, by the school district, by the county commissioners, we’ve been able to attract local foundation funding and then also work with the mayor’s office on applying for State dollars. And then most recently Federal applications to help with reentry which is where we get things calmed down for a time period and then we have people reentering society from prisons or jails.

And because there’s no direct resource for them to get reengaged in community, they find themselves going back into the same cycle. So it’s a myriad of streams of different revenue. And if someone has a specific question they can certainly go to and click on Omaha 360. And you can follow up more directly and I might be able to answer that question more specifically for you. But it is a mix of different streams that come in to help support these initiatives.

Lindsay Paulette-Chapman: Thank you so much.

We have one question for Dan—Dr. Dan Fisher.

The question is “Can you speak about how eCPR and Mental Health First Aid compare?”

Dan Fisher: Yes, I’d be glad to.

In fact Mental Health First Aid was an inspiration for us to develop Emotional CPR. When we first learned of Mental Health First Aid we thought it was terrific. This will help all citizens to help each other. But then we also saw—although it’s a beginning, it did not incorporate recovery because it was developed before recovery values and it didn’t really incorporate peer support.

And it’s more oriented towards identifying people who might have a diagnosable form of mental disorder and then referring them—and listening to them but then referring them fairly soon to professionals. And there certainly is a role for that. Emotional CPR is basically for everyone to help everyone. It’s not a mental health program. It’s a public health program. So it’s really to build healthy communities, and I think that’s one reason that Willie’s group was probably attracted to it.

Also, in Singapore we were alerted to this distinction because the Head of Long-Term care in Singapore came to me after several talks that I gave there and said “Is this mental health? Is Emotional CPR mental health?” And I said well, actually it’s broader. And she said, “Well that’s good because we don’t really want to focus just on diagnosing people and then referring them. We want to prevent people from developing mental disorders.”

So it’s a prevention tool. It’s a community education tool, and it helps either disasters or personal trauma.

Lindsay Paulette-Chapman: Thank you so much.

Next we have a comment for Willie. It says the Omaha report is very encouraging. One thing that needs to be added is that the first improvements are very often the biggest and least difficult. People may be less discouraged when progress slows if they know that’s normal and that they aren’t doing anything wrong—that they aren’t inadequate nor are they slipping.

Willie—do you have anything to add or thoughts on that?

Willie Barney: Yes. Thank you so much for the insightful comment because it is.

Like I mentioned, we’ve made tremendous progress. We came to the end of 2012 and we thought wow, we’d seen a 51 percent reduction during the summer months. We’ve increased our job programs. We come to the end of 2012 we had the lowest level in 7 years. And then we come through the spring. By April we had the lowest number of homicides that we’ve had in this area in over 10 years.

And then April, May, June we hit this horrific spike. And so we’ve always continued to push and develop a strategy to move. And it’s hard. I mean it’s hard to go through it but overall we continue to move forward. We intensify our efforts. We make adjustments. But it’s very insightful that communities—and I just want to mention that in our community—in our Nation—everyone is grappling with this issue of gun violence.

And I don’t know that we have really, really come to fully understand the impact, physical and emotionally, that this has on those communities where most of this gun violence specifically happens, and how do you deal with it when this issue comes up? Even though you may have a thousand people that graduated, more than you had 6 years ago, it only takes one incident to make the community feel like it’s not making progress.

So that’s a very insightful comment. But you have to keep pressing forward—keep moving forward and the long-term trends are moving in the right direction. But one homicide and one shooting is one too many for us so, we’ll—we won’t be finished until we don’t have any additional homicides in Omaha. So we have a long way to go. We have made progress.

But I encourage every community that you can make—you can definitely make progress. This can be solved. But it’s larger than just gun violence. It’s employment, it’s education, it’s housing, it’s health, it’s eCPR, all of these factors mixed together.

Lindsay Paulette-Chapman: Thank you Willie.

Let’s check with our operator. Do we have any questions on the phone?

Coordinator: Yes we do. Our first question comes from Karen.

Karen: Can you hear me?

Coordinator: Yes, we can hear you.

Karen: Hello. Oh, well people are asking questions about like resources—financial resources.

I guess I’m more interested in people’s personal journey, I guess. What inspires them and what were like their educational steps that they took to get to this place where they’re making these positive changes for any . . . ? I mean Dan Fisher and especially Willie; those are my questions.

Lindsay Paulette-Chapman: Great. Thank you for the question. Dan would you like to begin?

Dan, you might want to unmute yourself.

Dr. Daniel Fisher: Yes, it is easier to speak when I’m unmuted. Thank you.

So thank you for the question. It was an interesting question.

What motivates people to step forward? That’s what I heard in your question. And what motivated me to step forward really was my personal experience of recovery. I felt such a kinship, such empathy, to people in New Orleans and then Lake Charles after the hurricanes. And watching the pictures I felt I was right back in my own personal hurricane. It was interesting that Willie talked about sort of the personal hurricane in Omaha too.

And I think when you’ve been through suffering you feel connected through suffering. In fact that was one of things—one of our leaders sensed how we all felt so connected through suffering. And we can bring the recovery we’ve gone through and the hope that we’ve been able to develop—we bring that to other people who are in their own acute suffering. But there is something about the connection of suffering.

Lindsay Paulette-Chapman: Thank you.

Willie, do you have anything you’d like to talk . . .

Willie Barney: You know I’m right with Dan.

I think it’s something that all of us have within us, that there’s this call to make a difference. And it’s finding that place and the timing for when to step out. I literally for years had been waiting for someone else to try to rally the folks together and bring them together. Then after seeing, and I think experiencing, what happened with like what Dan said when the hurricanes hit in Louisiana. My family is from Mississippi and many lived in the Louisiana area. And so when I saw individuals coming to Omaha—that when we made that connection and I shared that many of my family members were from. And it just—there were so many other issues going on.

And I think it looks like it’s so overwhelming. Where do you start? I think where you start is stepping out and talking to others. I got in my car and went around and talked to other individuals. And they were all at the same point. They were just waiting for someone to say hey, let’s pull together, let’s have a meeting, let’s talk about this. We won’t solve it overnight but we know that we can make measurable progress. And I can tell you 7 years later we are making measurable progress. And we have more people joining in. And we have a long way to go.

But you’ve got to take that first step out there. And don’t try to solve it by yourself. Realize that no individual, no business, no health organization will solve this by themselves. But I think that in every one of these four stories you’ve heard today people joined with others and made a difference.

So thank you so much for the question.

Lindsay Paulette-Chapman: Thank you so much.

Both of you . . .

Dr. Daniel Fisher: I might add a little something to that. This is Dan Fisher.

And listening to Willie I’m reminded of another motivation that sustained my involvement. And that was the love of the people for both each other and for those of us coming in—the appreciation that they felt.

And also in—I’m from Massachusetts. It was a real cultural education by being in Louisiana. And I still carry many of the experiences with me. We would go out to lunch in between our trainings. And I’m from Massachusetts—Northeast, very goal-directed so, you know, 45 minutes lunch I’d stand up and say well how come nobody seems to be getting ready to leave? And they’d say enjoy yourself. Just sit down. This is part of our work.

Lindsay Paulette-Chapman: Nice.

Dr. Daniel Fisher: And it was, you know, étouffée and all the fixings, and the music at night. They’d take us all out for dancing. And I think sometimes we just neglect the having fun and music and entertainment and recreation.

Those are very valuable aspects of community building too.

Lindsay Paulette-Chapman: Thank you.

Great. Before we move on to the next question, I wondered if Margaret could talk about what’s inspired her to take such a positive role.

Margaret Upchurch: I was kind of hoping to get asked.

If you remember, in my bio, I lost my home, I lost my job, I lost my home, I lost everything. And I had a nervous breakdown and wound up in a hospital. And Journey to Wellness was there to help me. And as soon as I was able to give back, I had such a calling to do so because I don’t know where I’d be today without them. I really honestly don’t.

So for me it was to give back what was given to me. Thank you.

Lindsay Paulette-Chapman: Thank you so much.

The next question is asking about the effects of Ike in Houston, Texas, and Galveston, Texas.

Can maybe Marcie or Dan talk about . . . ?

Marcie Roth: This is Marcie. I’m not sure what the effects . . . . I’m not sure what the question is asking.

Lindsay Paulette-Chapman: Right. Perhaps—do any of you—were you involved in any of the response for Hurricane Ike?

Marcie Roth: I was. That was before I came to FEMA. And it was one of the disaster response experiences that I had where we were, you know, starting to engage as community members. I was very active in the disability community. And it was, you know, where post-Katrina there was more involvement of the disability community than ever before.

And, you know, I think there are folks today who are still very involved after their experience during that hurricane.

Lindsay Paulette-Chapman: Great. Thank you.

The next question is for Margaret Upchurch.

The question is “I’m wondering specifically about the scenario of wellness center—either employees or volunteers providing transportation for shelter victims to pharmacies, doctor’s appointments, etc. Were you able to coordinate volunteers providing transportation in their own vehicles? Or did you need to follow a specific agency protocol regarding approved drivers and liability insurance? I think the transportation piece is a huge need but I worry about the red tape standing in our way of providing this piece.” And the writer notes “I am with the Health Department in New York State.”


Margaret Upchurch: We actually had agency vehicles provided to us from the Mental Health Association in New Jersey. We were all drivers legally with the State of New Jersey. And Journey to Wellness, as an organization, does that on a regular basis. We do provide transportation every day to mental health appointments for our clients. And we didn’t actually take people to the pharmacies. We did all the running.

The only time we took people were to doctors, to the emergency room, to, you know, for kidney dialysis appointments. Yes the pharmacies—we ran around and did that without them. We got all their information. We called it into the pharmacy. And then we just drove from pharmacy to pharmacy to pharmacy.

I hope that answers your question.

Lindsay Paulette-Chapman: Thank you so much.

Maybe we’ll check with the operator. Is there a question on queue?

Coordinator: Yes, we do have a question from Patricia.

Patricia: Hello. I’m really happy to be on this call.

I work in New York City and I’m a director of a social service agency that works with families with a history of substance abuse, incarceration, and homelessness. I share that with you because I lived in the Zone 8 area and watched the entire area be devastated. I lived in Rockaway Park.

And so my question is around the type of support for employees who are also dealing with the trauma and aftermath of a storm. I know one of the things that really upset me during that time was that myself and other employees were told that they had to come to work. That if they didn’t come to work they were at risk of losing their jobs. If you didn’t have time on the book and—here we are, what are we 8, 10 months afterwards and as I supervise the staff on a regular basis I know in front of me is a worker but it’s also a person that is still dealing with a lot of trauma. And in many cases they do not have health coverage.

So I don’t know how complicated that question is but I was compelled from my heart to put it out there.

Lindsay Paulette-Chapman: Thank you so much for your question.

Do one of our speakers have thoughts or anything that you’d like to share?

Margaret Upchurch: Well, I can tell you as an employee—this is Margaret by the way—as an employee you have to have support and you have to get your people—if you’re concerned for your people—mental health support. I as a survivor still have things that I deal with from this storm. I have panic attacks in my sleep. If we have bad weather I don’t sleep, because I’m continually having panic attacks. But I am dealing with that and because I work where I work, I know that I have to take care of myself as well as others. But you have to take care of yourself first, because if you don’t do that, you’re not much good to anyone else.

So if there are local psychologists or therapists that you can refer your people to—I don’t know about your area but our area has places that do, for people that don’t have insurance—sliding scales. I mean it’s very important that they get that help and a lot of areas right now—like we’re doing Hope and Healing—there’s a lot of mental health facilities that are doing free counseling for people who’ve been traumatized by the storm. So you might look into that.

Patricia: Thank you.

Margaret Upchurch: In New Jersey we call it New Jersey Hope and Healing. And there’s in Ocean County where I live, there’s three different providers that are doing free counseling for people who survived Hurricane Sandy. So you might look into your mental health association in New York and they could probably refer you locally.

Lindsay Paulette-Chapman: Thank you so much.

Willie Barney: This is Willie.

I would just offer as well we’ve mentioned it a number of times on this call but eCPR. Even before we received the formalized training, we realized that we were doing some portions of it. And when the team came in and met with primarily the first group of 18 youths—outreach people that work with families that are just in sometimes just terrible situations. But the training helped us realize that we’ve got to make sure we take a minute and make sure that we’re okay. And that we’re dealing with people 24-7, and unless we take time and just make some connection ourselves, we’re putting ourselves in danger.

And I think we knew it. But I think to have a trainer come in and do this eCPR process and helping us really look at what are we doing to make sure we’re filled up and that we’re not fully—that we’re empty and we can’t serve anyone else. So I think often when you’re talking about being on a plane and they say you make sure you put your oxygen on first. And I think it’s eCPR is a good reminder of that. You can’t always be out there doing the work and not taking that time for yourself and for your own family. So it’s a very insightful question.

Dr. Daniel Fisher: Yes, Willie, I’m glad you brought that up. This is Dan Fisher.

As I was listening I was thinking about maybe viewing not just as mental health needs, but it’s human needs too. I think that’s what we do try to do with Emotional CPR. These are human needs.

So it doesn’t mean that a staff person necessarily needs a diagnosable condition or should even be treated as if they have a diagnosable condition at first. But just preventatively and through support and the expectation that the trauma has its impact.

And as Willie was saying actually—I love that analogy, you know, if you’re on a plane and there isn’t enough oxygen, you have to be sure to help yourself. We have something in Emotional CPR, we call it internal eCPR. And that is where you can’t really help the other person if you don’t feel connected. You can’t help the other person if you don’t feel, you know, in charge somewhat of your own life and feel vital.

So we do urge people who are helping other people to step back and tend to their own Emotional CPR, either with other workers or also inside through mindfulness, through meditation, through yoga—whatever you do to replenish yourself. It doesn’t have to be seen initially as even a mental health need, but a human need.

Lindsay Paulette-Chapman: Great. Thank you so much for all of your thoughtful questions and answers.

And unfortunately we are out of time right now. But if we were unable to take your question, you can reach out to the speakers directly or contact the ADS Center at

Contact information for each speaker is available on slide 96 and you can read more about each speaker on slides 97, 98, 99, and 100.

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We have come to the end of our time today. If you would like more—if you have more questions or you’d like to follow up, please contact the SAMHSA ADS Center by phone, fax, or email. The Web site is

On behalf of all of us at SAMHSA ADS Center, I want to extend our sincere appreciation to Dr. Daniel Fisher, Ms. Marcie Roth, Ms. Margaret Upchurch, and Mr. Willie Barney who have taught us about the essential role that every individual, including peers, can play in helping community become more resilient before, during, and after disasters or traumatic events.

Also, thanks to you, all of our listeners, for taking time out of your day to join us. Thank you in advance for completing our survey.